Coverage of internal iliac artery during endovascular abdominal aortic aneurysm repair may cause ischemic complications in buttock,intestine,lower extremity and genital.We reported nursing care of 72 patients in our center to investigate the key points of nursing.Our experience were as follows:individualized blood pressure management and doctor-nurse cooperation in pain management were key points in preoperative nursing;close postoperative observation was focused on ischemic colitis,buttock claudication and ischemic buttock skin;cooperation with ostomy care group improved pertinency of nursing care;rounding by integration of doctors and nurses obtained high satisfaction and improved patients' compliance.

Objective To investigate the relationship between HBV polymerase gene mutations and HBV genotypes in chronic hepatitis B (CHB) patients resistant to adefovir dipivoxil (ADV).Methods Blood samples were collected from 114 ADV-resistant CHB patients during February 2010 and May 2012.The HBV polymerase regions from serum samples were amplified with real-time PCR,and the PCR products were sequenced.Normal distribution data were presented as x ± s,and non-normal distribution data were presented as M (P25-P75) ; for homogeneous data analysis of variance and LSD-t test were performed.Results There were 8 types of HBV polymerase gene mutations in 114 CHB patients; single point mutation was detected in 102 patients (89.47％) and double or triple points mutations were detected in 12 patients (10.53％).rtA181V/T/S (57.89％),rtN236T (14.91％) and rtA181V/T/S + N236T (9.65％) were the predominant mutations.For 21 patients (18.42％) with HBV genotype B,rtN236T mutation was prevalent (47.62％,10/21) ; while for those with HBV genotype C (93,81.58％),rtA181V/T/S mutation was the predominant (65.59％,61/93).The differences of rtA181V/T/S (x2 =12.269,P ＜0.01) and rtN236T (x2 =18.658,P ＜0.01) mutation rates between B and C genotypes were statistically significant.Conclusion rtA181V/T/S,rtN236T and rtA181V/T/S + rtN236T are the major HBV polymerase gene mutation types in ADV resistant CHB patients,and mutation types are related with HBV genotypes.

This paper summarized key points of nursing care of 14 patients with acute iliofemoral vein thrombosis undergoing endovascular therapy via rheolytic thrombectomy system,including:assessing risk of acute pulmonary artery embolism with amendatory Geneva scale,perioperative refined management of hydrotherapy and protecting renal function,nursing care to prevent tissue and organ bleeding at different levels during catheterdirected thrombolytic therapy,and evaluating clinical effects of treatment and nursing with patented circumference measurer of lower extremity.The average duration of hospitalization was 4.42 d.Ten patients had hemoglobinuria and one had renal function impairment.Acute pulmonary artery embolism happened in one patient before surgery and catheter-directed thrombolytic therapy were performed in four patients due to unsatisfactory results of thrombectomy.

Objective To analyze the risk factors of occurrence of complications after fenestrated or branched endovascular aortic repair(F/B-EVAR)for complex thoracoabdominal aortic diseases.Meth-ods Clinical materials of 147 patients with F/B-EVAR for thoracoabdominal aortic diseases in the Department of Vascular Surgery of Drum Tower Hospital Affiliated to Medical College of Nanjing Uni-versity from 2021 to 2023 were retrospectively analyzed.Multivariate correlation analysis was used to explore the risk factors for postoperative complications during the mid-term follow-up.Results There were 13 postoperative deaths,with a mortality rate of 8.8％;52 patients experienced overall surgery-related complications,with an incidence rate of 35.4％;31 patients had postoperative endoleaks,with an endoleak rate of 21.1％;14 patients had branch stent-related endoleaks,involving 14 bran-ches;and 4 patients had branch occlusion,involving 5 branches.The re-intervention rate in this study was 20.4％(30/147),with 20 cases(13.6％)of postoperative renal insufficiency and 1 case of postoperative paraplegia due to spinal cord ischemia,as well as 1 case of postoperative stent infec-tion.Risk factor analysis for postoperative mortality,overall complications,endoleaks,and postoper-ative renal failure was conducted,and the risk factors for overall complications included preoperative renal insufficiency,aortic disease,aortic tortuosity angle＞60 °,and average number of branch re-constructions.The independent influencing factors for postoperative endoleaks included gender,age,history of renal insufficiency,history of thoracic endovascular aortic repair(TEVAR),aortic tortuosity angle＞60°,and true lumen diameter in thoracoabdominal aortic dissection(TAAD).The inde-pendent influencing factor for postoperative renal failure was preoperative renal insufficiency.Con-clusion Female,age,thoracoabdominal aortic aneurysm(TAAA),history of renal insufficiency,history of TEVAR,aortic tortuosity angle＞60°,and true lumen diameter in TAAD are the influen-cing factors for postoperative complications in patients with thoracoabdominal aortic diseases,and the possible related factors are TAAA sac diameter and TAAD false lumen diameter.

Objective To analyze the risk factors of occurrence of complications after fenestrated or branched endovascular aortic repair(F/B-EVAR)for complex thoracoabdominal aortic diseases.Meth-ods Clinical materials of 147 patients with F/B-EVAR for thoracoabdominal aortic diseases in the Department of Vascular Surgery of Drum Tower Hospital Affiliated to Medical College of Nanjing Uni-versity from 2021 to 2023 were retrospectively analyzed.Multivariate correlation analysis was used to explore the risk factors for postoperative complications during the mid-term follow-up.Results There were 13 postoperative deaths,with a mortality rate of 8.8％;52 patients experienced overall surgery-related complications,with an incidence rate of 35.4％;31 patients had postoperative endoleaks,with an endoleak rate of 21.1％;14 patients had branch stent-related endoleaks,involving 14 bran-ches;and 4 patients had branch occlusion,involving 5 branches.The re-intervention rate in this study was 20.4％(30/147),with 20 cases(13.6％)of postoperative renal insufficiency and 1 case of postoperative paraplegia due to spinal cord ischemia,as well as 1 case of postoperative stent infec-tion.Risk factor analysis for postoperative mortality,overall complications,endoleaks,and postoper-ative renal failure was conducted,and the risk factors for overall complications included preoperative renal insufficiency,aortic disease,aortic tortuosity angle＞60 °,and average number of branch re-constructions.The independent influencing factors for postoperative endoleaks included gender,age,history of renal insufficiency,history of thoracic endovascular aortic repair(TEVAR),aortic tortuosity angle＞60°,and true lumen diameter in thoracoabdominal aortic dissection(TAAD).The inde-pendent influencing factor for postoperative renal failure was preoperative renal insufficiency.Con-clusion Female,age,thoracoabdominal aortic aneurysm(TAAA),history of renal insufficiency,history of TEVAR,aortic tortuosity angle＞60°,and true lumen diameter in TAAD are the influen-cing factors for postoperative complications in patients with thoracoabdominal aortic diseases,and the possible related factors are TAAA sac diameter and TAAD false lumen diameter.